Trump promises 'something special' on health care before speech

The Trump administration designated the repeal and replace of Obamacare as its first priority ahead of a tax overhaul.

(Bloomberg)—President Donald Trump said his address to a joint session of Congress Tuesday will offer "something special" on his health-care overhaul efforts, as his administration gets increasingly involved with Republican plans to repeal and replace Obamacare. "We're going to be talking about it tomorrow night during the speech," Trump said during a meeting with top U.S. health insurance CEOs Monday at the White House. "I think you'll like what you hear."

Trump and congressional Republicans are pushing ahead with their efforts to repeal and replace the Affordable Care Act, the 2010 law also known as Obamacare. Their stated goals have sometimes been at odds -- with Trump promising better, less-expensive care for all, all while not touching entitlement programs like Medicare, and Republicans in Congress admitting that their plan is likely to cover fewer of the 20 million people who gained coverage under the ACA.

"The new plan will be a great plan for the patients, for the people and hopefully for the companies. Going to be a very competitive plan. And costs will come down and I think the health care will go up very, very substantially," Trump said Monday. "We've taken the best of everything we could take." His administration has promised a plan by mid-March.

Along with health insurers, Trump met with state governors over the last few days to discuss the ACA. Governors, whose states get billions of dollars annually from the health law, are weighing in, but haven't coalesced around their own set of proposals.

DIVIDED STATES

"Many states are divided on what the right approach is to take," Utah Governor Gary Herbert, a Republican, told reporters in Washington. He and other governors are in town for the winter meeting of the National Governors Association. Along with political disagreements in the House and Senate, Herbert said a key question yet to be answered is how to divvy up funding for Medicaid, the program for the poor, between states that expanded the program under Obamacare -- gaining large amounts of funding -- and those that didn't, like Utah.

"Maybe that's an impossibility but we need to get as close to fairness as we can," Herbert said Monday.

There's also the question of how many people who gained coverage under the law will be able to keep it. Nevada Governor Brian Sandoval, a Republican, said he was optimistic that people under the Medicaid expansion, like those in his state, would keep it.

"That's been a conversation this entire weekend," he said. "What I heard today made me feel good."

REPUBLICAN GOVERNORS

Another Republican governor, Kentucky's Matt Bevin, wasn't so sure. Too much attention was being paid to how many people were covered by the current law, rather than whether their health is improving. "It has not been successful anywhere, including in Kentucky," Bevin said.

Trump has painted the law as a failure. "The market is disastrous," Trump told the insurance executives Monday, referring to the marketplaces set up by Obamacare to sell coverage. Insurance premiums in the market are rising, and some major insurers have scaled back their offerings. "It's going to absolutely implode."

At the same time, support for Obamacare appears to be growing as threats to repeal it advance. Republicans home in their districts last week faced vocal, sometimes angry crowds defending Obamacare and saying Republicans should fix the law, not repeal it. And two polls released last week show increasing public support for the program.

INSURER MEETING

At the White House meeting with insurers were CEOs from UnitedHealth Group Inc., Aetna Inc., Anthem Inc., Cigna Corp., Humana Inc., Independence Blue Cross, Kaiser Permanente and BlueCross BlueShield of North Carolina.

After the session, Anthem CEO Joseph Swedish told reporters that the president signaled his desire to stabilize insurance markets under Obamacare. Aetna CEO Mark Bertolini, who's been critical of Obamacare and largely pulled his insurer out of the program, said Aetna wants to work with the administration and Congress on a "broader range of solutions that Americans will find valuable in managing their health-care needs."

Trump said Monday at the White House that he hoped that Democrats would cooperate, though they have pledged to resist GOP efforts to roll back the law.

"We are going to hopefully work with the Democrats because ultimately we're all people that love this country and we want to do the right thing, including reforms like expanded health-care savings accounts" and being able to purchase coverage across state lines, Trump said.

That's likely wishful thinking.

"We Democrats are steeled for the fight and it's already paying dividends," Senator Chuck Schumer of New York, the Democratic minority leader, told reporters Monday. Pointing to divisions between conservative and more moderate Republicans, he said there was still no agreement on what the GOP would do, nor would Democrats help them vote down the law.

"Republicans have not been able to pick off a single Democrat to support their plans," Schumer said. "I predict the discord in their party will grow as Republicans turn to Washington from this last week of angry town halls. I believe the odds are very high that we will keep the ACA and it will not be repealed."